WEBVTT 00:00:02.810 --> 00:00:12.220 JOANNE FARYON: Hello, I'm Joanne Faryon. 00:00:12.220 --> 00:00:15.610 Welcome to tonight's special, When Immunity Fails: 00:00:15.610 --> 00:00:17.790 The Whooping Cough Epidemic. 00:00:17.790 --> 00:00:21.560 We'll explore the worst whooping cough outbreak in California 00:00:21.560 --> 00:00:23.510 in more than 60 years. 00:00:23.510 --> 00:00:26.890 Just why is a disease that was nearly extinct thirty years ago, 00:00:26.890 --> 00:00:30.920 finding its way back not just in this state, but in other parts 00:00:30.920 --> 00:00:32.460 of the country as well? 00:00:32.460 --> 00:00:34.780 What we learned may surprise you. 00:00:34.780 --> 00:00:37.640 There are serious questions about how well the vaccine 00:00:37.640 --> 00:00:39.900 to prevent the disease works; 00:00:39.900 --> 00:00:42.310 questions government health officials have been slow 00:00:42.310 --> 00:00:44.130 to even ask. 00:00:44.130 --> 00:00:47.220 KPBS teamed up with the Watchdog Institute, 00:00:47.220 --> 00:00:48.960 an investigative journalism center 00:00:48.960 --> 00:00:51.230 at San Diego State University, 00:00:51.230 --> 00:00:54.450 and Radio Netherlands Worldwide to tell this story. 00:00:54.450 --> 00:00:57.000 A story that took us across California 00:00:57.000 --> 00:00:59.630 and overseas to Amsterdam. 00:00:59.630 --> 00:01:02.370 But first, we begin in a delivery room 00:01:02.370 --> 00:01:06.610 in a San Diego hospital, where a mother has just given birth 00:01:06.610 --> 00:01:12.540 to her third son. 00:01:12.540 --> 00:01:13.910 [ baby crying ] 00:01:13.910 --> 00:01:19.190 Matthew Jacob Bryce was born Oct 11, 2010. 00:01:19.190 --> 00:01:23.710 A healthy baby boy, the third boy for Cindy and Marlon Bryce. 00:01:23.710 --> 00:01:25.770 Matthew started showing signs of a cold 00:01:25.770 --> 00:01:27.450 when he was just two weeks old. 00:01:27.450 --> 00:01:29.730 The Bryce family knew something was wrong. 00:01:29.730 --> 00:01:31.340 MARLON BRYCE: So it just seemed 00:01:31.340 --> 00:01:35.640 like this cold it was just affecting his breathing. 00:01:35.640 --> 00:01:38.710 FARYON: The family was aware of the whooping cough epidemic 00:01:38.710 --> 00:01:40.540 in California, from news reports REPORTER: 00:01:40.540 --> 00:01:43.130 State health officials say more than 6,400 cases 00:01:43.130 --> 00:01:44.920 of whooping cough have been reported this year. 00:01:44.920 --> 00:01:46.710 FARYON: And their pediatrician. 00:01:46.710 --> 00:01:48.300 BRYCE: There wasn't any whooping 00:01:48.300 --> 00:01:52.520 or they always say there is a whooping or a cough, 00:01:52.520 --> 00:01:54.480 he didn't have a cough or anything it was just 00:01:54.480 --> 00:01:55.430 that there was a cold. 00:01:55.430 --> 00:01:58.620 FARYON: Matthew's doctor suspected it could be whooping 00:01:58.620 --> 00:02:00.810 cough, also known as pertussis. 00:02:00.810 --> 00:02:03.670 She took a nasal swab and sent it to the lab. 00:02:03.670 --> 00:02:06.500 She also started Matthew on antibiotics. 00:02:06.500 --> 00:02:09.970 Six days later, with Matthew just 23 days old, 00:02:09.970 --> 00:02:11.370 Cindy Bryce got a phone call 00:02:11.370 --> 00:02:13.480 from the California Department of Health. 00:02:13.480 --> 00:02:15.930 The diagnosis was whooping cough. 00:02:15.930 --> 00:02:20.860 M. BRYCE: The moment I heard it I just immediately started 00:02:20.860 --> 00:02:26.050 thinking the worst because you have heard the news 00:02:26.050 --> 00:02:28.690 about the babies that have passed away. 00:02:28.690 --> 00:02:31.770 FARYON: From January to October this year, 00:02:31.770 --> 00:02:35.060 10 newborns in California died from whooping cough, 00:02:35.060 --> 00:02:37.160 two in San Diego County. 00:02:37.160 --> 00:02:40.450 More than 7,000 children and adults got sick 00:02:40.450 --> 00:02:43.370 from the disease - the highest number in the state 00:02:43.370 --> 00:02:45.200 in more than 60 years. 00:02:45.200 --> 00:02:48.880 Just how did Matthew and so many others come down with a disease 00:02:48.880 --> 00:02:51.960 that is supposed to be preventable with a vaccine? 00:02:51.960 --> 00:02:53.970 Tonight we'll raise questions 00:02:53.970 --> 00:02:56.910 about the effectiveness of that vaccine. 00:02:56.910 --> 00:03:01.410 A four-month investigation by KPBS and the Watchdog Institute, 00:03:01.410 --> 00:03:03.860 found many people who have been diagnosed 00:03:03.860 --> 00:03:07.140 with whooping cough were immunized. 00:03:07.140 --> 00:03:09.910 We also show how government data on the number 00:03:09.910 --> 00:03:13.350 of people diagnosed with whooping cough lacks timeliness 00:03:13.350 --> 00:03:16.680 and is often inconsistent, begging the question: 00:03:16.680 --> 00:03:19.590 just who is keeping track of this epidemic? 00:03:19.590 --> 00:03:21.650 We'll show you how some of the experts 00:03:21.650 --> 00:03:25.210 who influence vaccine policy are financially tied 00:03:25.210 --> 00:03:27.040 to vaccine companies. 00:03:27.040 --> 00:03:29.390 And, we'll follow the Bryce family as they struggle 00:03:29.390 --> 00:03:33.490 with their son's diagnosis, and the setbacks in his recovery. 00:03:33.490 --> 00:03:40.640 Whooping cough, violent cough, the hundred-day cough; 00:03:40.640 --> 00:03:42.370 all names for pertussis. 00:03:42.370 --> 00:03:44.920 DR. JAMES CHERRY: What causes the cough actually we 00:03:44.920 --> 00:03:45.690 don't know... 00:03:45.690 --> 00:03:47.450 there's no other cough quite like it. 00:03:47.450 --> 00:03:50.840 FARYON: Pertussis is a respiratory illness caused 00:03:50.840 --> 00:03:53.430 by the bacterium bordetella pertussis. 00:03:53.430 --> 00:03:55.530 At first, it can mimic a cold. 00:03:55.530 --> 00:03:59.070 But later produces a violent and persistent cough, 00:03:59.070 --> 00:04:02.090 a cough that leaves children gasping for air - 00:04:02.090 --> 00:04:05.200 creating the distinct whooping sound. 00:04:05.200 --> 00:04:08.380 For adults, whooping cough may only be a nuisance. 00:04:08.380 --> 00:04:11.260 In fact scientists estimate more than 80 percent 00:04:11.260 --> 00:04:14.130 of adult cases are never diagnosed 00:04:14.130 --> 00:04:17.260 because most people assume they just have a bad cold. 00:04:17.260 --> 00:04:20.500 But to infants whooping cough can be deadly, 00:04:20.500 --> 00:04:22.950 especially if not diagnosed early. 00:04:22.950 --> 00:04:25.390 DR. JAMES CHERRY: So with infection 00:04:25.390 --> 00:04:29.850 that you eventually clear the bacteria and you get better. 00:04:29.850 --> 00:04:34.120 But it's a prolonged, a good percentage 00:04:34.120 --> 00:04:38.930 of cases will last one or two months. 00:04:38.930 --> 00:04:42.210 DR. FRITS MOOI: After a pertussis infection it has been 00:04:42.210 --> 00:04:44.870 shown to get super infections, in fact that is one 00:04:44.870 --> 00:04:47.090 of the main complications, pneumonia. 00:04:47.090 --> 00:04:50.240 FARYON: Young babies aren't able to cough up secretions 00:04:50.240 --> 00:04:52.610 that collect in their lungs, leading to pneumonia 00:04:52.610 --> 00:04:54.930 and making it difficult to breathe. 00:04:54.930 --> 00:04:59.490 Early antibiotic treatment is most critical in this age group. 00:04:59.490 --> 00:05:02.630 Whooping cough was nearly wiped out by the late 1970's 00:05:02.630 --> 00:05:04.910 because of mass immunization, 00:05:04.910 --> 00:05:07.400 but it's somehow found its way back to California 00:05:07.400 --> 00:05:11.290 and other highly vaccinated communities around the world. 00:05:11.290 --> 00:05:14.070 Just why it's made such a vengeful comeback has two 00:05:14.070 --> 00:05:17.580 of the world's leading whooping cough experts in disagreement. 00:05:17.580 --> 00:05:20.270 Dr. James Cherry of UCLA: CHERRY: 00:05:20.270 --> 00:05:22.530 The main reason is increased awareness. 00:05:22.530 --> 00:05:25.120 FARYON: and Dr. Frits Mooi of the Netherlands Centre 00:05:25.120 --> 00:05:26.950 for Infectious Diseases Control. 00:05:26.950 --> 00:05:33.350 MOOI: We found really a new mutation in the bug. 00:05:33.350 --> 00:05:37.120 FARYON: Dr. Mooi and Dr. Cherry both began their research 00:05:37.120 --> 00:05:39.750 into Whooping Cough about 30 years ago. 00:05:39.750 --> 00:05:42.940 Cherry in the U.S. and Mooi in The Netherlands. 00:05:42.940 --> 00:05:45.620 The two scientists know each other's work. 00:05:45.620 --> 00:05:49.790 CHERRY: First of all, his molecular microbiological is, 00:05:49.790 --> 00:05:54.990 he's right at the top of scholars. 00:05:54.990 --> 00:05:57.370 There's no question about that. 00:05:57.370 --> 00:06:02.150 I think where some of the things he's published is the clinical 00:06:02.150 --> 00:06:04.060 data are not very good. 00:06:04.060 --> 00:06:07.290 MOOI: I don't communicate too much with him but what he wrote 00:06:07.290 --> 00:06:11.590 in the press is that I screw up epidemiology. 00:06:11.590 --> 00:06:13.440 That doesn't help me too much. 00:06:13.440 --> 00:06:16.490 FARYON: To understand why these two experts disagree, 00:06:16.490 --> 00:06:18.570 you need to know a little about the history 00:06:18.570 --> 00:06:19.850 of the pertussis vaccine. 00:06:19.850 --> 00:06:23.710 ANNOUNCER: Since most serious cases occur before school age, 00:06:23.710 --> 00:06:26.120 immunization in school may be too late. 00:06:26.120 --> 00:06:29.340 FARYON: The bacteria that causes whooping cough was first 00:06:29.340 --> 00:06:32.100 isolated in Belgium in 1906. 00:06:32.100 --> 00:06:33.850 At the time, the illness was one 00:06:33.850 --> 00:06:35.700 of the leading causes of infant death. 00:06:35.700 --> 00:06:40.680 ANNOUNCER: In 1921, whooping cough killed 316 00:06:40.680 --> 00:06:42.560 Michigan children. 00:06:42.560 --> 00:06:47.310 Last year, the number of deaths was reduced to 63. 00:06:47.310 --> 00:06:51.340 FARYON: The discovery lead to the first attempts at a vaccine. 00:06:51.340 --> 00:06:55.250 But it wasn't until the late 1940's scientists developed a 00:06:55.250 --> 00:06:58.010 vaccine effective enough to prevent whooping cough. 00:06:58.010 --> 00:06:59.920 ANNOUNCER: Unlike the disease however, 00:06:59.920 --> 00:07:01.670 a vaccine does not endanger life. 00:07:01.670 --> 00:07:05.350 FARYON: By 1946, mass immunization programs began 00:07:05.350 --> 00:07:08.850 in the U.S. and the number of cases dropped dramatically. 00:07:08.850 --> 00:07:10.790 Prior to the vaccine the rate 00:07:10.790 --> 00:07:14.800 of disease was 157 cases per 100,000. 00:07:14.800 --> 00:07:19.810 By the 1970's, with large scale immunizations, fewer than one 00:07:19.810 --> 00:07:22.670 in one hundred thousand people got whooping cough. 00:07:22.670 --> 00:07:26.220 But the vaccine was not without controversy. 00:07:26.220 --> 00:07:29.340 The early versions were associated with side effects 00:07:29.340 --> 00:07:32.970 such as prolonged crying spells and seizures in babies. 00:07:32.970 --> 00:07:37.630 By 1996, the FDA approved a new whooping cough vaccine. 00:07:37.630 --> 00:07:40.170 It was called an acellular version. 00:07:40.170 --> 00:07:43.270 That means the vaccine uses only purified components 00:07:43.270 --> 00:07:45.620 of the disease-causing organism. 00:07:45.620 --> 00:07:49.080 That vaccine was considered to be safer and associated 00:07:49.080 --> 00:07:51.320 with few mild side effects. 00:07:51.320 --> 00:07:56.770 Today, the U.S. uses only the acellular pertussis vaccine. 00:07:58.100 --> 00:08:02.940 But as the United States was changing vaccines something else 00:08:02.940 --> 00:08:06.650 was happening - health officials 00:08:06.650 --> 00:08:09.740 across the country were reporting increasing numbers 00:08:09.740 --> 00:08:12.160 of positive whooping cough cases. 00:08:12.160 --> 00:08:16.140 And in a government lab about 30 minutes outside of Amsterdam, 00:08:16.140 --> 00:08:19.190 a group of scientists had discovered something else - 00:08:19.190 --> 00:08:22.320 the bacterium that causes whooping cough started 00:08:22.320 --> 00:08:23.990 to look a little different. 00:08:23.990 --> 00:08:28.690 MOOI: This new mutation had the effect that the bacteria started 00:08:28.690 --> 00:08:30.520 to produce more pertussis toxin. 00:08:30.520 --> 00:08:32.800 FARYON: Just whether that mutation is to blame, 00:08:32.800 --> 00:08:35.490 at least in part, for the California epidemic 00:08:35.490 --> 00:08:38.350 and outbreaks elsewhere in the world is at the heart 00:08:38.350 --> 00:08:40.260 of the whooping cough debate. 00:08:40.260 --> 00:08:44.450 Dr. Mooi believes this to be the case, but not Dr. Cherry. 00:08:44.450 --> 00:08:47.230 CHERRY: Even though these changes have occurred there is 00:08:47.230 --> 00:08:51.110 no evidence that that's lead to increased vaccine failure. 00:08:56.040 --> 00:08:59.670 FARYON: Here in San Diego County, more than 85 percent 00:08:59.670 --> 00:09:01.400 of children are immunized. 00:09:01.400 --> 00:09:03.190 In fact, less than three percent 00:09:03.190 --> 00:09:06.860 of kids entering kindergarten have not been immunized 00:09:06.860 --> 00:09:09.070 because of their family's personal beliefs. 00:09:09.070 --> 00:09:11.770 But despite the high immunization rate, 00:09:11.770 --> 00:09:14.510 San Diego has the second largest number 00:09:14.510 --> 00:09:17.660 of positive whooping cough cases in California. 00:09:17.660 --> 00:09:20.760 Dr. Dean Sidelinger is San Diego's deputy public 00:09:20.760 --> 00:09:21.710 health officer. 00:09:21.710 --> 00:09:22.710 DR. DEAN SIDELINGER: This is a disease 00:09:22.710 --> 00:09:25.150 that if someone has it it's very easy to transfer 00:09:25.150 --> 00:09:26.770 from one person to another. 00:09:26.770 --> 00:09:29.100 So if you or I sitting here during this interview, 00:09:29.100 --> 00:09:32.090 one of us had pertussis chances are we could transmit 00:09:32.090 --> 00:09:33.470 that to the other person. 00:09:33.470 --> 00:09:34.990 Sidelinger says in the past, 00:09:34.990 --> 00:09:37.990 the number of whooping cough cases peaked in summer 00:09:37.990 --> 00:09:41.690 and slowed by fall, but this year, that didn't happen. 00:09:41.690 --> 00:09:45.350 SIDELINGER: So as time goes on we're seeing more cases. 00:09:45.350 --> 00:09:48.950 We know that public awareness plays into that as we talk 00:09:48.950 --> 00:09:51.480 about pertussis more people are asking their doctors 00:09:51.480 --> 00:09:53.230 and doctors are asking their patients we're going 00:09:53.230 --> 00:09:55.410 to see more, but that trend continued. 00:09:55.410 --> 00:09:59.530 FARYON: By the end of November 2010, nearly 1000 infants, 00:09:59.530 --> 00:10:02.830 children and adults in San Diego County tested positive 00:10:02.830 --> 00:10:04.050 for whooping cough. 00:10:04.050 --> 00:10:06.760 More than half of them had been immunized. 00:10:06.760 --> 00:10:08.090 Our investigation shows 00:10:08.090 --> 00:10:10.890 that trend continues throughout California. 00:10:10.890 --> 00:10:14.190 KPBS and The Watchdog Institute collected data 00:10:14.190 --> 00:10:16.950 from 9 California counties that report some 00:10:16.950 --> 00:10:19.050 of the highest infection rates. 00:10:19.050 --> 00:10:22.590 Our research shows that where immunization history is known, 00:10:22.590 --> 00:10:26.240 between 44 and 83 percent of people diagnosed 00:10:26.240 --> 00:10:28.650 with whooping cough were vaccinated. 00:10:28.650 --> 00:10:30.370 We looked at California Department 00:10:30.370 --> 00:10:32.430 of Public Health records too. 00:10:32.430 --> 00:10:35.460 In cases where vaccination history was recorded, 00:10:35.460 --> 00:10:39.090 more than 80 percent of infected people had been immunized. 00:10:39.090 --> 00:10:41.050 DR. MARK HORTON: From the epidemiology experts 00:10:41.050 --> 00:10:45.780 and the experts in vaccine that this is absolutely expected. 00:10:45.780 --> 00:10:48.220 FARYON: Dr. Mark Horton is the director 00:10:48.220 --> 00:10:50.740 of the California Department of Public Health. 00:10:50.740 --> 00:10:52.560 HORTON: If you've got a percentage 00:10:52.560 --> 00:10:56.340 of the population vaccinated and a percentage of those vaccinated 00:10:56.340 --> 00:10:57.440 that are still susceptible 00:10:57.440 --> 00:11:00.820 because the vaccine isn't perfectly effective or effective 00:11:00.820 --> 00:11:02.800 in all individuals, when you work 00:11:02.800 --> 00:11:05.050 out the arithmetic you'll see that even 00:11:05.050 --> 00:11:06.980 with a very effective vaccine, 00:11:06.980 --> 00:11:08.360 and even if you have the majority 00:11:08.360 --> 00:11:10.300 of the population vaccinated, 00:11:10.300 --> 00:11:14.130 the pool of susceptibles will include a number of individuals 00:11:14.130 --> 00:11:15.390 that have never been vaccinated 00:11:15.390 --> 00:11:19.390 but will also include quite a few and in some cases greater 00:11:19.390 --> 00:11:20.240 than 50 percent 00:11:20.240 --> 00:11:22.350 of the individuals have been previously vaccinated. 00:11:22.350 --> 00:11:24.670 FARYON: In other words, if you do the math, 00:11:24.670 --> 00:11:26.720 you will always find a certain number 00:11:26.720 --> 00:11:28.620 of immunized people getting sick 00:11:28.620 --> 00:11:31.650 if a vaccine is not 100 percent effective. 00:11:31.650 --> 00:11:34.930 HORTON: So that's no surprise to us nor is it a reflection 00:11:34.930 --> 00:11:36.520 on the efficacy of the vaccine. 00:11:36.520 --> 00:11:37.890 REPORTER KEVIN CROWE: It's not a reflection 00:11:37.890 --> 00:11:39.070 on the efficacy of the vaccine? 00:11:39.070 --> 00:11:39.690 HORTON: Correct, correct. 00:11:39.690 --> 00:11:42.560 FARYON: But 20 years ago, the reverse was true. 00:11:42.560 --> 00:11:44.990 According to a report by the Centers for Disease Control, 00:11:44.990 --> 00:11:48.420 more than half of the children between 3 months and 4 years old 00:11:48.420 --> 00:11:51.450 who got whooping cough nationwide between 1990 00:11:51.450 --> 00:11:53.900 and 1996 were not immunized. 00:11:53.900 --> 00:11:56.480 The rate of whooping cough has also been increasing 00:11:56.480 --> 00:11:58.050 for the past 20 years. 00:11:58.050 --> 00:12:00.900 From less than one in 100,000 00:12:00.900 --> 00:12:04.250 to 18 per 100,000 here in California. 00:12:04.250 --> 00:12:08.580 And in some California counties such as San Luis Obispo, 00:12:08.580 --> 00:12:12.880 rates are nearly as high as before vaccines were developed. 00:12:12.880 --> 00:12:14.910 Two days after our interview 00:12:14.910 --> 00:12:18.630 with the Bryce family, Matthew got a fever. 00:12:18.630 --> 00:12:21.480 He was hospitalized at Rady's Children's Hospital 00:12:21.480 --> 00:12:24.000 in San Diego. 00:12:24.000 --> 00:12:26.820 Matthew was not immunized against whooping cough. 00:12:26.820 --> 00:12:28.060 He's too young. 00:12:28.060 --> 00:12:31.900 Babies can't be immunized until they're two months old. 00:12:31.900 --> 00:12:34.880 But everyone else in the Bryce family was vaccinated - 00:12:34.880 --> 00:12:37.160 even his parents got booster shots. 00:12:37.160 --> 00:12:39.400 The practice of immunizing everyone 00:12:39.400 --> 00:12:42.030 around a newborn baby is called cocooning. 00:12:42.030 --> 00:12:46.860 CINDY BRYCE: When I called the doctor they asked me who has it 00:12:46.860 --> 00:12:50.390 and I couldn't give them an answer because I don't know 00:12:50.390 --> 00:12:53.460 where he got it from because everyone's been vaccinated. 00:12:53.460 --> 00:12:56.550 FARYON: Myron and one of his sons were also tested 00:12:56.550 --> 00:12:58.390 for whooping cough - both were negative. 00:12:58.390 --> 00:13:00.990 M. BRYCE: The one thing I would want 00:13:00.990 --> 00:13:05.740 to know is the vaccine working? 00:13:05.740 --> 00:13:11.300 Is it as effective because before this I thought the 00:13:11.300 --> 00:13:18.710 vaccine was working and I thought that if I did everything 00:13:18.710 --> 00:13:27.220 that I was told to do that our sons would be protected. 00:13:27.220 --> 00:13:30.140 FARYON: Just how effective is the vaccine? 00:13:30.140 --> 00:13:32.700 That all depends on who you talk to. 00:13:32.700 --> 00:13:34.250 Drug information included 00:13:34.250 --> 00:13:37.110 with the two most commonly used whooping cough vaccines 00:13:37.110 --> 00:13:40.410 in the US say the vaccine is 85 percent effective. 00:13:40.410 --> 00:13:44.120 MOOI: This new strain has completely invaded the 00:13:44.120 --> 00:13:46.490 Netherlands and also other countries and pushed 00:13:46.490 --> 00:13:48.290 out all the other strains. 00:13:48.290 --> 00:13:49.090 It's quite unique. 00:13:49.090 --> 00:13:51.660 FARYON: Dr. Mooi believes there's no way 00:13:51.660 --> 00:13:54.480 to determine how effective the vaccines are 00:13:54.480 --> 00:13:56.130 because they have not been tested 00:13:56.130 --> 00:13:58.390 against the new strain of whooping cough. 00:13:58.390 --> 00:13:59.740 MOOI: We call it the p3 strain. 00:13:59.740 --> 00:14:02.550 FARYON: A strain he believes is more virulent 00:14:02.550 --> 00:14:04.000 and can make people sicker. 00:14:04.000 --> 00:14:07.540 This strain emerged while the new acellular vaccines were 00:14:07.540 --> 00:14:08.380 being developed. 00:14:08.380 --> 00:14:09.510 MOOI: I can tell you one 00:14:09.510 --> 00:14:14.320 of the reasons the vaccine companies is not too happy 00:14:14.320 --> 00:14:20.750 with me is because if what I say is true they selected the wrong 00:14:20.750 --> 00:14:22.980 strains the in the 1980's. 00:14:22.980 --> 00:14:25.440 FARYON: Mooi's lab was studying the new strain 00:14:25.440 --> 00:14:28.620 when The Netherlands experienced an unexpected whooping cough 00:14:28.620 --> 00:14:30.270 epidemic in 1996. 00:14:30.270 --> 00:14:32.150 MOOI: There were more strains in fact 00:14:32.150 --> 00:14:35.070 when you compare the two there was a very direct relationship 00:14:35.070 --> 00:14:38.110 between the emergence of these strains, we call them p3 strains 00:14:38.110 --> 00:14:40.640 and the increase in pertussis notifications. 00:14:40.640 --> 00:14:44.820 CHERRY: There's absolutely no evidence that either 00:14:44.820 --> 00:14:48.870 of the two vaccines that are most common today used 00:14:48.870 --> 00:14:54.330 in the U.S. that there is increased vaccine failure 00:14:54.330 --> 00:14:56.020 with either of those vaccines. 00:14:56.020 --> 00:15:01.130 FARYON: So if you had to explain why we're seeing this epidemic 00:15:01.130 --> 00:15:03.080 the highest number of cases in 60 years, 00:15:03.080 --> 00:15:04.690 what would you tell people? 00:15:04.690 --> 00:15:07.560 CHERRY: The main reason is increased awareness. 00:15:07.560 --> 00:15:12.500 People, particularly public health people are much more 00:15:12.500 --> 00:15:14.890 aware and that trickles down. 00:15:14.890 --> 00:15:17.560 FARYON: Cherry says the increase is also due in part 00:15:17.560 --> 00:15:19.890 because of something called waning immunity. 00:15:19.890 --> 00:15:23.500 Immunity to whooping cough does not last a lifetime, 00:15:23.500 --> 00:15:26.440 whether you are vaccinated or develop natural immunity 00:15:26.440 --> 00:15:27.960 from getting the disease. 00:15:27.960 --> 00:15:31.590 Almost all experts agree waning immunity is contributing 00:15:31.590 --> 00:15:34.350 to whooping cough outbreaks worldwide. 00:15:34.350 --> 00:15:39.420 Where they disagree: when does immunity fail? 00:15:39.420 --> 00:15:45.300 Dr. Mooi believes the new strain of pertussis causes immunity 00:15:45.300 --> 00:15:47.400 to fail sooner than in the past. 00:15:47.400 --> 00:15:49.180 And he's published his findings 00:15:49.180 --> 00:15:52.510 in several peer reviewed journals including the CDC's 00:15:52.510 --> 00:15:54.010 Infectious Diseases. 00:15:54.010 --> 00:15:59.280 MOOI: When the immunity is sub-optimal what will happen the 00:15:59.280 --> 00:16:04.300 bacteria will not be recognized very well by the immune system 00:16:04.300 --> 00:16:08.330 because of the mismatch and second of all even 00:16:08.330 --> 00:16:10.710 if immune response is started 00:16:10.710 --> 00:16:14.740 in the body the toxin will be able to delay it. 00:16:14.740 --> 00:16:19.920 You could say these two changes work together 00:16:19.920 --> 00:16:22.460 by decreasing the period 00:16:22.460 --> 00:16:25.830 of which the vaccine is protective further. 00:16:25.830 --> 00:16:27.900 FARYON: The Netherlands learned something else 00:16:27.900 --> 00:16:30.350 after its 1996 epidemic. 00:16:30.350 --> 00:16:33.320 At the time, it had very few samples of the bacteria 00:16:33.320 --> 00:16:35.850 that was causing people to get sick. 00:16:35.850 --> 00:16:38.790 So Mooi's lab began asking doctors and their labs 00:16:38.790 --> 00:16:41.460 to send him positive pertussis swabs. 00:16:41.460 --> 00:16:44.700 His lab now has 3,000 samples. 00:16:44.700 --> 00:16:47.920 California that has collected just 29 samples from the more 00:16:47.920 --> 00:16:51.550 than 7,000 whooping cough cases in the state. 00:16:51.550 --> 00:16:55.080 During the KPBS/Watchdog four month investigation, 00:16:55.080 --> 00:16:57.170 we also learned data kept by the state 00:16:57.170 --> 00:17:00.890 and the CDC was often lagging behind county data 00:17:00.890 --> 00:17:02.700 and was inconsistent. 00:17:02.700 --> 00:17:05.860 While counties like San Diego knew the immunization status 00:17:05.860 --> 00:17:08.540 of the vast majority of people with whooping cough, 00:17:08.540 --> 00:17:11.770 the state's data listed the information as unknown. 00:17:11.770 --> 00:17:15.180 Despite statewide protocols for reporting pertussis, 00:17:15.180 --> 00:17:19.230 a KPBS/Watchdog survey found some counties don't follow them 00:17:19.230 --> 00:17:22.140 or are slow to report the information HORTON: 00:17:22.140 --> 00:17:24.930 There's a perception that the more numbers the better, 00:17:24.930 --> 00:17:30.460 but let me be very clear we in no way need reports 00:17:30.460 --> 00:17:33.050 on every single case of pertussis for us 00:17:33.050 --> 00:17:37.040 to make important judgments and decisions 00:17:37.040 --> 00:17:38.330 about what's happening. 00:17:38.330 --> 00:17:41.490 FARYON: The CDC in Atlanta declined our requests 00:17:41.490 --> 00:17:42.570 for an interview. 00:17:42.570 --> 00:17:45.480 In an email response they said it is "difficult 00:17:45.480 --> 00:17:49.380 to disentangle all the factors" contributing to increases 00:17:49.380 --> 00:17:52.870 in pertussis, but listed "increasing transmission, 00:17:52.870 --> 00:17:54.360 better recognition, 00:17:54.360 --> 00:17:57.300 and increased laboratory confirmation." 00:17:57.300 --> 00:18:00.300 We also asked whether a new more virulent strain could be 00:18:00.300 --> 00:18:02.060 contributing to the outbreak. 00:18:02.060 --> 00:18:05.790 The CDC's response: "Available data do not suggest 00:18:05.790 --> 00:18:08.350 that ptxP3 is more virulent, 00:18:08.350 --> 00:18:11.420 or that increasing reports are attributable only 00:18:11.420 --> 00:18:14.270 to the emergence of ptxP3. 00:18:14.270 --> 00:18:18.360 We continue to work on this and other potential explanations 00:18:18.360 --> 00:18:20.460 for the increase in pertussis 00:18:20.460 --> 00:18:23.780 that has occurred since the 1980s." 00:18:23.780 --> 00:18:26.940 The CDC sent us this study by their own investigators. 00:18:26.940 --> 00:18:28.180 The study looked at children 00:18:28.180 --> 00:18:30.950 between 6 months and five years old. 00:18:30.950 --> 00:18:33.080 It found pertussis vaccines to be more 00:18:33.080 --> 00:18:35.240 than 90 percent effective. 00:18:35.240 --> 00:18:39.600 The study looked at data between 1998 and 2001. 00:18:39.600 --> 00:18:42.710 It did not collect pertussis strain information. 00:18:42.710 --> 00:18:46.850 SINGING: Do you happen to know what a T-dap is? 00:18:46.850 --> 00:18:53.260 It's a special vaccine but it's not just for kids. 00:18:53.260 --> 00:18:55.940 FARYON: Sanofi Pastuer, one of two companies 00:18:55.940 --> 00:18:59.360 that make the vaccine widely used in the U.S., 00:18:59.360 --> 00:19:02.330 sponsored this singing competition earlier this year. 00:19:02.330 --> 00:19:07.070 SINGING: Persussis is the reason why you should call your 00:19:07.070 --> 00:19:09.010 doctor today. 00:19:09.010 --> 00:19:11.410 FARYON: It was a public relations exercise 00:19:11.410 --> 00:19:15.040 to get the word out about whooping cough and immunization. 00:19:15.040 --> 00:19:18.320 But just where is the line between good PR and trying 00:19:18.320 --> 00:19:20.750 to influence public health policy? 00:19:20.750 --> 00:19:23.990 SINGING: Take a shot and give pertussis a whooping. 00:19:23.990 --> 00:19:28.700 FARYON: Especially when public health policy can increase 00:19:28.700 --> 00:19:30.140 vaccine sales. 00:19:30.140 --> 00:19:33.040 Since 2007, the California department 00:19:33.040 --> 00:19:36.030 of health has spent more than $200 million 00:19:36.030 --> 00:19:39.430 on pertussis vaccines for children on medical 00:19:39.430 --> 00:19:41.060 or who are under-insured. 00:19:41.060 --> 00:19:43.510 And it's sure to rise. 00:19:43.510 --> 00:19:47.840 In September, the California state legislature passed a law 00:19:47.840 --> 00:19:50.810 requiring all students to receive another does, 00:19:50.810 --> 00:19:54.200 a sixth dose of the pertussis vaccine before entering 00:19:54.200 --> 00:19:55.360 middle school. 00:19:55.360 --> 00:19:57.110 It may be a case of what's good 00:19:57.110 --> 00:19:59.850 for business is also good for public health. 00:19:59.850 --> 00:20:02.340 But how much influence does industry have 00:20:02.340 --> 00:20:04.150 over public health policy? 00:20:04.150 --> 00:20:06.470 Sanofi Pasteur also established 00:20:06.470 --> 00:20:09.390 and funds The Global Pertussis Initiative. 00:20:09.390 --> 00:20:13.340 A group made up of medical experts from around the world. 00:20:13.340 --> 00:20:15.720 The GPI was established 10 years ago 00:20:15.720 --> 00:20:19.980 to study why pertussis was making a comeback and find ways 00:20:19.980 --> 00:20:21.550 to control the disease. 00:20:21.550 --> 00:20:23.340 More than half its members are employees 00:20:23.340 --> 00:20:25.050 of the pharmaceutical company 00:20:25.050 --> 00:20:28.170 or receive research money or consulting fees. 00:20:28.170 --> 00:20:31.460 Public officials from across the country, including California 00:20:31.460 --> 00:20:34.880 and the CDC, site the Global Pertussis Initiative 00:20:34.880 --> 00:20:37.210 when making vaccine policy. 00:20:37.210 --> 00:20:40.140 Dr. James Cherry is a member of the initiative. 00:20:40.140 --> 00:20:43.240 He's also received speaking fees and research funds 00:20:43.240 --> 00:20:45.320 from vaccine manufacturers. 00:20:45.320 --> 00:20:48.080 At the same time, he sat on government committees 00:20:48.080 --> 00:20:51.420 to help determine vaccine policy and efficacy. 00:20:51.420 --> 00:20:56.450 FARYON: A cynic might say that if you have a community 00:20:56.450 --> 00:21:01.260 of experts in pertussis as in the Global Pertussis Initiative, 00:21:01.260 --> 00:21:03.940 who primarily their work in terms 00:21:03.940 --> 00:21:06.370 of this endeavor is being funded by the drug company 00:21:06.370 --> 00:21:10.120 that makes the vaccine, there might be less incentive 00:21:10.120 --> 00:21:13.810 to say make a new vaccine and more incentive 00:21:13.810 --> 00:21:16.410 to say just use the old one more often. 00:21:16.410 --> 00:21:17.840 What do you say to them? 00:21:17.840 --> 00:21:19.920 CHERRY: I don't think that's true. 00:21:19.920 --> 00:21:25.500 I think that we've been talking about new vaccines. 00:21:25.500 --> 00:21:32.490 It think the difficulty with the new vaccine lies in the expense 00:21:32.490 --> 00:21:39.420 that it would cost to make a new vaccine and the difficulty 00:21:39.420 --> 00:21:46.040 in testing it and FDA requirements for it and I think 00:21:46.040 --> 00:21:48.880 if the climate was right for two 00:21:48.880 --> 00:21:52.270 of the major manufacturers they would do it. 00:21:52.270 --> 00:21:55.480 MOOI: And these are three different pertussis strains. 00:21:55.480 --> 00:21:59.220 FARYON: Dr. Mooi is a critic of the Pertussis Initiative. 00:21:59.220 --> 00:22:04.630 MOOI: My big disappointment is they have totally 00:22:04.630 --> 00:22:09.090 and I think willfully ignored pathogen adaptation. 00:22:09.090 --> 00:22:15.500 I think a few years ago we had the year 00:22:15.500 --> 00:22:21.110 that Darwin died 100 year ago, it was not so long ago, 00:22:21.110 --> 00:22:25.460 I think it's very strange that evolution 00:22:25.460 --> 00:22:29.180 and pathogen adaptation is completely ignored 00:22:29.180 --> 00:22:30.200 by such a group. 00:22:30.200 --> 00:22:35.060 I find that bad for science and bad for public health. 00:22:35.060 --> 00:22:38.140 FARYON: Sanofi Pastuer released this statement to KPBS 00:22:38.140 --> 00:22:40.310 and the Watchdog Institute. 00:22:40.310 --> 00:22:44.150 It says its grant to the GPI brings the world's authorities 00:22:44.150 --> 00:22:48.500 on pertussis together and that benefits society as a whole. 00:22:48.500 --> 00:22:50.930 The company also says "at the present time, 00:22:50.930 --> 00:22:54.860 there is no evidence to suggest current pertussis vaccines 00:22:54.860 --> 00:22:56.800 lack effectiveness." 00:22:56.800 --> 00:23:00.640 Dr. Dean Sidelinger was one of the first health officials 00:23:00.640 --> 00:23:03.770 to learn immunized people were getting sick in his county. 00:23:03.770 --> 00:23:06.780 He said he was surprised, but in the end, 00:23:06.780 --> 00:23:10.760 he says the current vaccine is still the best thing he's got 00:23:10.760 --> 00:23:12.280 to protect his community. 00:23:12.280 --> 00:23:14.090 SIDELINGER: It does significantly decrease the 00:23:14.090 --> 00:23:17.010 pertussis we see a significantly lower number 00:23:17.010 --> 00:23:20.190 of pertussis cases now then we saw before we started using 00:23:20.190 --> 00:23:21.280 the vaccine. 00:23:21.280 --> 00:23:25.050 So we don't want people to feel complacent to say I don't want 00:23:25.050 --> 00:23:27.340 that vaccine because I've seen many of the cases 00:23:27.340 --> 00:23:29.810 that have been reported were fully vaccinated. 00:23:29.810 --> 00:23:32.430 FARYON: Sidelinger says there would be many more cases 00:23:32.430 --> 00:23:34.700 if there was no vaccine at all. 00:23:34.700 --> 00:23:36.040 Dr. Mooi agrees. 00:23:36.040 --> 00:23:38.960 He believes public health officials should be encouraging 00:23:38.960 --> 00:23:43.500 cocooning, immunizing all those around newborn babies. 00:23:43.500 --> 00:23:48.940 But in the long run, he says we need better vaccines. 00:23:48.940 --> 00:23:51.800 Baby Matthew spent four days in the hospital 00:23:51.800 --> 00:23:54.250 and was eventually discharged. 00:23:54.250 --> 00:23:57.400 Today, he's getting his two-month routine check-up. 00:23:57.400 --> 00:24:00.100 DOCTOR: I think it was just back luck he's had two illnesses 00:24:00.100 --> 00:24:04.500 in a row and now the cold he's building up his immunity. 00:24:04.500 --> 00:24:08.160 FARYON: Despite a stuffy nose, Matthew is doing well today. 00:24:08.160 --> 00:24:11.270 DCOTOR: As you might know the vaccine is not 00:24:11.270 --> 00:24:13.160 as effective as we want it to be. 00:24:13.160 --> 00:24:17.210 And that's one reason why there've been a lot of cases. 00:24:17.210 --> 00:24:21.850 But with Matthew in particular, his own immunity has kicked 00:24:21.850 --> 00:24:24.690 in from having the illness, that is, in effect a sort 00:24:24.690 --> 00:24:27.520 of a booster that will protect him going forward. 00:24:27.520 --> 00:24:31.110 And how long that immunity lasts is still a question. 00:24:31.110 --> 00:24:34.200 MARLON: The one thing I would want to say 00:24:34.200 --> 00:24:42.070 to parents is just watch your kids, just be concerned. 00:24:42.070 --> 00:24:50.700 Because at first we thought we were being over protective. 00:24:50.700 --> 00:24:57.360 But I'm glad we were just a little bit over-concerned. 00:24:57.360 --> 00:25:00.910 FARYON: Since KPBS and the Watchdog Institute began its 00:25:00.910 --> 00:25:04.540 investigation, state health officials, the CDC 00:25:04.540 --> 00:25:08.160 and scientists from UCLA, including Dr. James Cherry, 00:25:08.160 --> 00:25:11.590 began a new study to determine whether the new strain 00:25:11.590 --> 00:25:13.450 of pertussis is contributing 00:25:13.450 --> 00:25:15.990 to the current whooping cough outbreak. 00:25:15.990 --> 00:25:18.610 For more on this story, and to see more of the data collected 00:25:18.610 --> 00:25:24.370 in our investigation, go to kpbs.org/whoopingcough 00:25:24.370 --> 00:25:27.760 and watchdoginstitute.org. 00:25:27.760 --> 00:25:30.210 For KPBS, the Watchdog Institute 00:25:30.210 --> 00:25:33.410 and Radio Netherlands Worldwide, I'm Joanne Faryon. 00:25:33.410 --> 00:26:45.650 Thanks for watching.